2025 CPT code 35666
(Active) Effective Date: N/A Surgery - Cardiovascular System Surgery Feed
Bypass graft, with other than vein; femoral-anterior tibial, posterior tibial, or peroneal artery.
Modifiers may be applicable to indicate specific circumstances, such as increased procedural services (22), bilateral procedures (50), or distinct procedural services (59).
Medical necessity must be established by documenting the severity of the peripheral arterial disease, symptoms, failed conservative treatment, and the need to restore blood flow to the limb.
The surgeon is responsible for all aspects of the procedure, including prepping the patient, creating the bypass graft, ensuring proper blood flow, and closing the incision.
In simple words: This surgery creates a detour around a blocked artery in the thigh. The surgeon uses a tube-like graft to redirect blood flow from the thigh artery to an artery in the calf, bypassing the blockage.
This procedure involves creating a bypass around a blocked femoral artery using a synthetic graft. The graft reroutes blood flow from the femoral artery to the anterior tibial, posterior tibial, or peroneal artery in the calf.The surgeon makes an incision in the upper thigh, prepares the graft, clamps the affected femoral artery, and attaches one end of the graft. The other end is attached to the chosen artery in the calf after creating a tunnel for the graft. The surgeon then checks for leaks and confirms graft patency, often using arteriography or ultrasound.
Example 1: A patient with severe peripheral artery disease in the leg has a blockage in the femoral artery, restricting blood flow to the lower leg. A femoral-popliteal bypass is performed using a synthetic graft to restore circulation., A patient with critical limb ischemia and a blocked femoral artery requires a bypass to the peroneal artery using a synthetic graft to salvage the limb and prevent amputation., A patient with a failed previous femoral-tibial bypass using a vein graft now requires a new bypass to the anterior tibial artery using a synthetic graft.
Documentation should include details of the blockage location, the type of graft used, the target artery for bypass, intraoperative findings, and confirmation of graft patency.
- Revenue Code: P2F
- Payment Status: Inpatient Only (as of 2017)
- Specialties:Vascular Surgery, Cardiothoracic Surgery
- Place of Service:Inpatient Hospital